Claim total
$13,855.72
base $93.83 · payer covered $13,855.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-05-27
- Stop
- 2025-05-27
The parties
- Patient
- patient Rocio Margarita Alcaraz
- Provider
- provider Deloras Lesch
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
0274bb53-c777-eb96-6667-411cca486ba8